Developing environmental health indicators [EHIs] for Iran based on the causal effect model.

Environmental health monitoring and its effects on health are very important in health systems. Relationship between environment and health can be done by simplifying data in understandable indicators for people and policy-makers. The present study presents the general framework for formulating environmental health quality index for Iran.This study was implemented through expert panel at two levels: indicator domain determination and domain specific variables selection. Domain specific variables were selected based on the Driving force-Pressure-State-Exposure-Effect-Action (DPSEEA) framework from the list of national and international variables.Seven environmental health issues [air quality, drinking water, sewage disposal, food, radiation management and housing and human settlements] were determined, and three variables were selected for air quality, 8 variables for water quality, 5 variables for sanitation, 1 variable for food quality, 3 variables for housing and human settlements, 4 variables for solid waste management and 3 variables for radiation management.Environmental health indicators determination based on the causal effect model leads to a better understanding of the relationship between the environment and health by simplifying data in an understandable format for public and improves prioritization of policy-making in the environmental health. In this study, environmental health indicators for Iran were proposed.